Navegando por Autor "Morais, Maria Helena Franco"
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Item Disentangling associations between vegetation greenness and dengue in a Latin American city : findings and challenges.(2021) Cunha, Maria da Consolação Magalhães; Ju, Yang; Morais, Maria Helena Franco; Dronova, Iryna; Ribeiro, Sérvio Pontes; Bruhn, Fábio Raphael Pascoti; Lima, Larissa Lopes; Sales, Denise Marques; Schultes, Olivia Lang; Rodriguez, Daniel A.; Caiaffa, Waleska TeixeiraBeing a Re-Emerging Infectious Disease, dengue causes 390 million cases globally and is prevalent in many urban areas in South America. Understanding the fine-scale relationships between dengue incidence and environmental and socioeconomic factors can guide improved disease prevention strategies. This ecological study examines the association between dengue incidence and satellite-based vegetation greenness in 3826 census tracts nested in 474 neighborhoods in Belo Horizonte, Brazil, during the 2010 dengue epidemic. To reduce potential bias in the estimated dengue-greenness association, we adjusted for socioeconomic vulnerability, population density, building height and density, land cover composition, elevation, weather patterns, and neighborhood random effects. We found that vegetation greenness was negatively associated with dengue incidence in a univariate model, and this association attenuated after controlling for additional covariates. The dengue-greenness association was modified by socioeconomic vulnerability: while a positive association was observed in the least vulnerable census tracts, the association was negative in the most vulnerable areas. Using greenness as a proxy for vegetation quality, our results show the potential of vegetation management in reducing dengue incidence, particularly in socioeconomically vulnerable areas. We also discuss the role of water infrastructure, sanitation services, and tree cover in lowering dengue risk.Item Effectiveness of the Brazilian Visceral Leishmaniasis Surveillance and Control Programme in reducing the prevalence and incidence of Leishmania infantum infection.(2018) Rocha, Iara Caixeta Marques da; Santos, Letícia Helena Marques dos; Vital, Wendel Coura; Cunha, Gisele Macedo Rodrigues da; Magalhães, Fernanda do Carmo; Silva, Thais Almeida Marques da; Morais, Maria Helena Franco; Oliveira, Edward; Reis, Ilka Afonso; Carneiro, MariângelaBackground Control strategies adopted by the Brazilian Visceral Leishmaniasis Surveillance and Control Programme (VLSCP) include identifying and culling seropositive infected dogs, early diagnosis and treatment of human cases, chemical control of the vector and population awareness. This study evaluated the effectiveness of the VLSCP on the prevalence and incidence rates of Leishmania infantum in children residing in areas under different VLSCP intervention times. Methods A quasi-experimental epidemiological study with a panel (two cross-sectional) and a concurrent cohort was performed in three areas of Belo Horizonte, southeast Brazil. The first cross-sectional study (I) was carried out with 1875 children, 478 of which were enrolled in the cohort study. In the second cross-sectional study (II), 413 additional children were included, totalizing 891 children. Laboratory diagnosis was performed by ELISA-rK39. Analyses included multilevel logistic and Poisson regression models. Results The incidence rates of L. infantum infection were: 14.4% in the area where VLSCP intervention was initiated in 2006 (AI2006); 21.1% in the area where intervention was initiated in 2008 (AI2008); and 11.6% in the area where intervention was initiated in 2010 (AI2010 - control area). A follow-up period of 24 months showed that the persons-time incidence rates in AI2006, AI2008, and AI2010 were: 6.2/100, 10/100, and 5.6/100 persons/24 months, respectively. The final prevalence rates of infection (cross-sectional II - in 2012), compared to the initial rates (cross-sectional I - in 2010), increased 83.7% in AI2006, 74.1% in AI2008, and decreased 5% in AI2010. Analysis of the effectiveness revealed that children residing in AI2008 are more likely to be infected (OR = 1.84; 95% CI: 1.06-3.23) and present a higher risk of infection (IRR = 1.76; 95% CI: 1.05-2.95) compared to those in AI2010. No statistically significant differences were observed in asymptomatic infection (OR and IRR) in AI2006 compared to AI2010. Conclusions The VLSCP was not effective at controlling L. infantum infection in areas where interventions had respectively been carried out for six and four years. However, it is unclear what the consequences in terms of human infection and diseases would be in the absence of the VLSCP. Efforts to improve the effectiveness of control measures remain a necessary priority.Item Evaluation of change in canine diagnosis Protocol adopted by the visceral Leishmaniasis control program in Brazil and a new proposal for diagnosis.(2014) Vital, Wendel Coura; Ker, Henrique Gama; Roatt, Bruno Mendes; Soares, Rodrigo Dian de Oliveira Aguiar; Leal, Gleisiane Gomes de Almeida; Moreira, Nádia das Dores; Oliveira, Laser Antônio Machado de; Machado, Evandro Marques de Menezes; Morais, Maria Helena Franco; Oliveira, Rodrigo Corrêa de; Carneiro, Mariângela; Reis, Alexandre BarbosaThe techniques used for diagnosis of canine visceral leishmaniasis (CVL) in Brazil ELISA and IFAT have been extensively questioned because of the accuracy of these tests. A recent change in the diagnosis protocol excluded IFAT and included the Dual-Path Platform (DPP). We evaluated the prevalence and incidence rates of Leishmania spp. before and after the change in the protocol. In addition, based on our results, we propose a new alternative that is less expensive for the screening and confirmation of CVL. Plasma samples were obtained from a serobank from dogs evaluated in a cross-sectional study (1,226 dogs) and in a cohort study of susceptible animals (n = 447), followed for 26 months. Serology testing wasperformed using ELISA, IFAT, and DPP. The incidence and prevalence of CVL were determined by using the protocol of the Visceral Leishmaniasis Control and Surveillance Program until 2012 (ELISA and IFAT using filter paper) and the protocol used after 2012 (DPP and ELISA using plasma). The prevalence was 6.2% and the incidence was 2.8 per 1,000 dog-months for the protocol used until 2012. For the new diagnosis protocol for CVL resulted in an incidence of 5.4 per 1,000 dog-months and a prevalence of 8.1%. Our results showed that the prevalence and incidence of infection were far greater than suggested by the previously used protocol and that the magnitude of infection in endemic areas has been underestimated. As tests are performed sequentially and euthanasia of dogs is carried out when the serological results are positive in both tests, the sequence does not affect the number of animals to be eliminated by the Control Program. Then we suggest to municipalities with a large demand of exams to use ELISA for screening and DPP for confirmation, since this allows easier performance and reduced cost.Item Influence of climatic variables on the number of cases of visceral leishmaniasis in an endemic urban area.(2022) Duarte, Rafael Vieira; Monteiro, Josefa Clara Lafuente; Cruz, Tamara Coelho; Ribeiro, Lucas Moreira; Morais, Maria Helena Franco; Carneiro, Mariângela; Reis, Alexandre Barbosa; Ribeiro, Sérvio Pontes; Vital, Wendel CouraBackground Visceral leishmaniasis (VL) is a neglected tropical disease endemic in several countries, with as much as 97% of cases in the Americas attributable to Brazil. Despite considerable investment in disease control, Belo Horizonte is one of the Brazilian municipalities with the highest mortality rates. The present study aimed to investigate the association between climatic variables and the increase in the number of VL cases in Belo Horizonte. Methods The study analyzed 1,897 laboratory-confirmed cases of VL registered by the municipality’s Epidemiological Surveillance from 1994 to 2019. The climatic variables were obtained from the National Institute of Meteorology. Results The first reported VL case was detected in 1994, and since then, the disease has spread throughout the municipality. The disease was most common in the very young age groups, 1 to 4 years, and older groups, 40 to 49 years old. Approximately 63% of detected cases were men. A peak number of cases were observed in 2004, 2006, 2008 and 2017. Total precipitation was significantly associated with the number of VL cases, with more cases depending on rainfall (P=0.006), thus confirming that climate contributes to the disease spread. Conclusions These results demonstrate the need for the actions of the Visceral Leishmaniasis Surveillance and Control Program to be reinforced in years with above-average rainfall, a situation that is increasingly more frequent in Southeastern Brazil due to global climate change.Item Prevalence and factors associated with leishmania infantum infection of dogs from an urban area of Brazil as identified by molecular methods.(2011) Vital, Wendel Coura; Marques, Marcos José; Veloso, Vanja Maria; Roatt, Bruno Mendes; Soares, Rodrigo Dian de Oliveira Aguiar; Reis, Levi Eduardo Soares; Braga, Samuel Leôncio; Morais, Maria Helena Franco; Reis, Alexandre Barbosa; Carneiro, MariângelaVisceral leishmaniasis (VL) is a disease caused by the parasite Leishmania infantum , and dogs are the most important domestic reservoirs of the agent. During recent decades, VL has expanded to large Brazilian urban centers. In the present work, we have demonstrated by using molecular techniques that the rate of canine infection as detected by serology has been considerably underesti mated. Two groups of seronegative dogs (infected and non-infected according to molecular methods) were further evaluated from data obtained through interviews with owners of the animals. The factors associated with Leishmania infection in dogs were a family income of less than two minimum salaries, the knowledge of the owner regarding the vector, the dog spending most of its time in the backyard and the dog never having had a previous serological examination. Awareness regarding the factors associated with canine infection will improve health services and the understanding of the disease’s expansion in urban areas.Item Spatial and temporal trends of visceral leishmaniasis by mesoregion in a southeastern state of Brazil, 2002-2013.(2017) Silva, Thais Almeida Marques da; Vital, Wendel Coura; Barbosa, David Soeiro; Oiko, Carla Sayuri Fogaça; Morais, Maria Helena Franco; Tourinho, Bruna Dias; Melo, Diogo Portella Ornelas de; Reis, Ilka Afonso; Carneiro, MariângelaThis article presents the spatial and temporal distribution of visceral leishmaniasis (VL) in Minas Gerais State and identifies the greater risk areas of transmission. This study is both timely and substantive because Minas Gerais is an important Brazilian state in the number of cases of visceral leishmaniasis. The results showed that during the 12-year time series the VL had a heterogeneous spatial and temporal distribution in the state of Minas Gerais. Among the 12 existing mesoregions, six (Central Mineira, Jequitinhonha, Metropolitan area of Belo Horizonte, Northwest of Minas, North of Minas, and Vale do Rio Doce) were responsible for the expansion and maintenance of VL in the state. Among them, the Vale do Rio Doce and Jequitinhonha mesoregions presented a considerable increase in the incidence rates of the disease in the last period. In the other six mesoregions only sporadic cases of the disease were reported during the study period. The results of in this study may contribute to a better understanding the dynamic of the disease in Minas Gerais. Also these findings can provide subsidies to assist the actions of the control program of VL.Item Spatiotemporal dynamics and risk estimates of COVID-19 epidemic in Minas Gerais State : analysis of an expanding process.(2021) Vital, Wendel Coura; Cardoso, Diogo Tavares; Ker, Fabricio Thomaz de Oliveira; Magalhães, Fernanda do Carmo; Bezerra, Juliana Maria Trindade; Viegas, Ana Maria; Morais, Maria Helena Franco; Bastos, Leonardo Soares; Reis, Ilka Afonso; Carneiro, Mariângela; Barbosa, David SoeiroCOVID-19 is an infectious disease caused by the recently discovered coronavirus SARS-Cov-2. The disease became pandemic affecting many countries globally, including Brazil. Considering the expansion process and particularities during the initial stages of the epidemic, we aimed to analyze the spatial and spatiotemporal patterns of COVID-19 occurrence and to identify priority risk areas in Minas Gerais State, Southeast Brazil. An ecological study was performed considering all data from human cases of COVID-19 confirmed from the epidemiological week (EW) 11 (March 08, 2020) to EW 26 (June 27, 2020). Crude and smoothed incidence rates were used to analyze the distribution of disease patterns based on global and local indicators of spatial association and space-time risk assessment. Positive spatial autocorrelation and spatial dependence were found. Our results suggest that the metropolitan region of the State capital Belo Horizonte (MRBH) and Vale do Rio Doce mesoregions, as major epidemic foci in the beginning of the expansion process, have had important influence on the dispersion of SARS-CoV-2 in Minas Gerais State. Triangulo Mineiro/Alto Paranaiba region presented the highest risk of infection. In addition, six statistically significant spatiotemporal clusters were identified in the State, three at high risk and three at low risk. Our findings contribute to a greater understanding of the space-time disease dynamic and discuss strategies for identification of priority areas for COVID-19 surveillance and control.Item Visceral leishmaniasis in large Brazilian cities : challenges for control.(2008) Oliveira, Cláudia Di Lorenzo; Morais, Maria Helena Franco; Coelho, George Luiz Lins MachadoThe objectives of this article were to discuss the rapid spread of visceral leishmaniasis in urban areas of Brazil and to raise practical questions and perspectives related to control of the disease. Among the proposed methods, the elimination of seropositive dogs is the most controversial and least accepted by society. Its impact on incidence rates varies among studies (positive in some and relatively unimportant in others). Treatment of infected dogs, although widespread in veterinary practice, is based on studies with weak scientific evidence. Insecticide spraying of areas is more acceptable to the population, but is costly and operationally difficult. Intra and inter-urban factors have scarcely been studied and may affect control of the disease. Finally, the article discusses the use of deltamethrin-impregnated dog collars and vaccines, with high expectations for impact on disease transmission, although no product currently available on the market has been fully evaluated, so that further studies are required.Item Worldwide COVID-19 spreading explained : traveling numbers as a primary driver for the pandemic.(2020) Ribeiro, Sérvio Pontes; Cruz, Wesley Francisco Dáttilo da; Barbosa, David Soeiro; Vital, Wendel Coura; Chagas, Igor Aparecido Santana das; Silva, Alcides Volpato Carneiro de Castro e; Morais, Maria Helena Franco; Góes Neto, Aristóteles; Azevedo, Vasco Ariston de Carvalho; Fernandes, Geraldo Wilson Afonso; Reis, Alexandre BarbosaThe spread of SARS-CoV-2 and the distribution of cases worldwide followed no clear biogeographic, climatic, or cultural trend. Conversely, the internationally busiest cities in all countries tended to be the hardest hit, suggesting a basic, mathematically neutral pattern of the new coronavirus early dissemination. We tested whether the number of flight passengers per time and the number of international frontiers could explain the number of cases of COVID-19 worldwide by a stepwise regression. Analysis were taken by 22 May 2020, a period when one would claim that early patterns of the pandemic establishment were still detectable, despite of community transmission in various places. The number of passengers arriving in a country and the number of international borders explained significantly 49% of the variance in the distribution of the number of cases of COVID-19, and number of passengers explained significantly 14.2% of data variance for cases per million inhabitants. Ecological neutral theory may explain a considerable part of the early distribution of SARS-CoV-2 and should be taken into consideration to define preventive international actions before a next pandemic.